Brief Answer: First try malathion 0.5% then oral ivermectin Detailed Answer: Hi Mam, I have gone through your query; for effective elimination of head lice I personally suggests 1. Combing two times a day. 2. Treat all family members that are also infested at a time. 3. Malathion (Ovide) 0.5% as a first-line agent for the treatment of head lice. It is a combination drug and is mixed with isopropyl alcohol (rubbing alcohol) and terpineol (a naturally occurring tea tree oil extract). If above treatment fails then go for the oral ivermectin tablet because in resistant head lice infestations, oral ivermectin is better than malathion. If you have any doubt, I will be available for your query.